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Rheumatology Advance Access originally published online on January 29, 2009
Rheumatology 2009 48(4):383-385; doi:10.1093/rheumatology/ken515
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Do temporal artery duplex ultrasound findings correlate with ophthalmic complications in giant cell arteritis?

Wolfgang A. Schmidt1, Andreas Krause1, Bernd Schicke2, Jörn Kuchenbecker3 and Erika Gromnica-Ihle1

1Medical Centre for Rheumatology Berlin-Buch, 2Department of Statistics, Tumor Centrum Berlin and 3Department of Ophthalmology, Helios Klinikum Berlin-Buch, Berlin, Germany.

Correspondence to: Wolfgang A. Schmidt, Medical Centre for Rheumatology Berlin-Buch, Lindenberger Weg 19, 13125 Berlin, Germany. E-mail: schmidt.wa{at}t-online.de


  Abstract

Objective. Ophthalmic complications are common in acute GCA. Do temporal artery ultrasound and clinical parameters correlate with the occurrence and severity of ophthalmic complications?

Methods. The results of temporal artery ultrasound examinations are compared with the occurrence of anterior ischaemic optic neuropathy (AION), central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), diplopia and amaurosis fugax in 222 consecutive patients with newly diagnosed, active GCA.

Results. Temporal artery ultrasound displayed vasculitic wall swelling (halo), stenoses and/or acute occlusions in 84% (58% in 67 large-vessel GCA patients and 95% in 155 patients without proximal arm vasculitis). Ophthalmic complications occurred in 64 (29%), AION in 30 (14%), CRAO in 7 (3%), BRAO in 2 (1%), amaurosis fugax in 16 (7%) and diplopia in 9 patients (4%). Ophthalmic complications were insignificantly more common if temporal artery ultrasound was positive (31 vs 17%; P = 0.11) as a greater number of patients without arm vasculitis showed eye involvement (34 vs 18%; P = 0.02). The number of pathological temporal artery segments, presence of stenoses or bilateral findings did not correlate with ophthalmic complications. Age >= 72 yrs at diagnosis correlated with a higher incidence of ophthalmic complications.

Conclusion. Ophthalmic complications occurred less frequently if proximal arm vasculitis was present. Findings of temporal artery ultrasound did not correlate with eye complications.

KEY WORDS: GCA, Ultrasonography, Histology, Anterior ischaemic optic neuropathy, Amaurosis fugax, Diplopia, Central retinal artery occlusion, Branch retinal artery occlusion

Submitted 9 August 2008; revised version accepted 22 December 2008.
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